Evaluating primary care performance in the Western Cape: a follow-up study using the Primary Care Assessment Tool

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dc.contributor.advisorVon Pressentin, Klaus Botho
dc.contributor.authorWeenink, Johanna Sophia
dc.date.accessioned2026-06-30T08:35:38Z
dc.date.available2026-06-30T08:35:38Z
dc.date.issued2026
dc.date.updated2026-06-30T08:34:19Z
dc.description.abstractBackground: Primary health care is a fundamental pillar of universal health coverage, ensuring accessible, equitable, and cost-effective health services. The Western Cape Department of Health and Wellness prioritises strengthening primary care to advance universal health coverage. However, resource constraints, service delivery inefficiencies, and accessibility gaps persist. This study aimed to evaluate the performance and progress of primary healthcare in the Western Cape province over time using the Primary Care Assessment Tool. Methods: A repeated cross-sectional study was conducted at four public-sector primary care facilities. The Primary Care Assessment Tool was administered between June 2015 and March 2016 (timeframe 1) and repeated between August 2023 and January 2024 (timeframe 2). Results: For the follow-up study, data from 48 patients, 15 healthcare providers, and eight managers were analysed. Compared to timeframe 1, patient-reported scores declined in timeframe 2, while provider and manager ratings remained stable. Although the median primary care score and the extended score remained within ‘acceptable to good', the percentage of patients who agreed declined, whereas the percentage of managers increased. The change in primary care score was not statistically significant (p-value 0.582), but the primary care extended score showed a significant difference (p-value <0.001). Ongoing care was the only domain that scored <3 across all respondent categories (p-value 0.005). Among patients, access to care received the lowest score (mean 1.7; CI 1.2-3.4). Conclusion: Disparities between patient experiences and staff evaluations highlight the need for targeted improvements in healthcare delivery. Addressing these gaps can help policymakers make informed decisions, optimise resource distribution, and implement strategic interventions to enhance patient experiences and outcomes. Contribution: The Primary Care Assessment Tool remains a valuable instrument for bridging the gap between patient perspectives and clinical evaluations, thereby supporting the shift toward evidence-based, patient-centred healthcare. Repeated assessments provide critical insights into performance trends over time.
dc.identifier.apacitationWeenink, J. S. (2026). <i>Evaluating primary care performance in the Western Cape: a follow-up study using the Primary Care Assessment Tool</i>. (). University of Cape Town ,Faculty of Health Sciences ,Division of Public Health. Retrieved from http://hdl.handle.net/11427/43414en_ZA
dc.identifier.chicagocitationWeenink, Johanna Sophia. <i>"Evaluating primary care performance in the Western Cape: a follow-up study using the Primary Care Assessment Tool."</i> ., University of Cape Town ,Faculty of Health Sciences ,Division of Public Health, 2026. http://hdl.handle.net/11427/43414en_ZA
dc.identifier.citationWeenink, J.S. 2026. Evaluating primary care performance in the Western Cape: a follow-up study using the Primary Care Assessment Tool. . University of Cape Town ,Faculty of Health Sciences ,Division of Public Health. http://hdl.handle.net/11427/43414en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Weenink, Johanna Sophia AB - Background: Primary health care is a fundamental pillar of universal health coverage, ensuring accessible, equitable, and cost-effective health services. The Western Cape Department of Health and Wellness prioritises strengthening primary care to advance universal health coverage. However, resource constraints, service delivery inefficiencies, and accessibility gaps persist. This study aimed to evaluate the performance and progress of primary healthcare in the Western Cape province over time using the Primary Care Assessment Tool. Methods: A repeated cross-sectional study was conducted at four public-sector primary care facilities. The Primary Care Assessment Tool was administered between June 2015 and March 2016 (timeframe 1) and repeated between August 2023 and January 2024 (timeframe 2). Results: For the follow-up study, data from 48 patients, 15 healthcare providers, and eight managers were analysed. Compared to timeframe 1, patient-reported scores declined in timeframe 2, while provider and manager ratings remained stable. Although the median primary care score and the extended score remained within ‘acceptable to good', the percentage of patients who agreed declined, whereas the percentage of managers increased. The change in primary care score was not statistically significant (p-value 0.582), but the primary care extended score showed a significant difference (p-value <0.001). Ongoing care was the only domain that scored <3 across all respondent categories (p-value 0.005). Among patients, access to care received the lowest score (mean 1.7; CI 1.2-3.4). Conclusion: Disparities between patient experiences and staff evaluations highlight the need for targeted improvements in healthcare delivery. Addressing these gaps can help policymakers make informed decisions, optimise resource distribution, and implement strategic interventions to enhance patient experiences and outcomes. Contribution: The Primary Care Assessment Tool remains a valuable instrument for bridging the gap between patient perspectives and clinical evaluations, thereby supporting the shift toward evidence-based, patient-centred healthcare. Repeated assessments provide critical insights into performance trends over time. DA - 2026 DB - OpenUCT DP - University of Cape Town KW - Performance KW - Primary Care LK - https://open.uct.ac.za PB - University of Cape Town PY - 2026 T1 - Evaluating primary care performance in the Western Cape: a follow-up study using the Primary Care Assessment Tool TI - Evaluating primary care performance in the Western Cape: a follow-up study using the Primary Care Assessment Tool UR - http://hdl.handle.net/11427/43414 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/43414
dc.identifier.vancouvercitationWeenink JS. Evaluating primary care performance in the Western Cape: a follow-up study using the Primary Care Assessment Tool. []. University of Cape Town ,Faculty of Health Sciences ,Division of Public Health, 2026 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/43414en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDivision of Public Health
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectPerformance
dc.subjectPrimary Care
dc.titleEvaluating primary care performance in the Western Cape: a follow-up study using the Primary Care Assessment Tool
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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